Re: Paralyzed vocal cord/swallowing/choking

October 4, 2002

-

Suzanne -

I am truly sorry to hear of the problems you have because I can

sympathize. I had my tt on 9/5 and immediately after surgery,

everything was fine. however, by the 2nd day, my voice became a bit

weak and i had some of the swallowing probems. my problems, although

not as severe as yours was the same, trouble swallowing (especially

liquid) as it would feel like things were trickling down the wrong

tube and cause me to choke. I would also have some shortness of

breath, especially if i try to talk too much.

i had a follow up/post op with my surgeon on 9/13 and he told me that

my problems were due to my throat area " healing " . because i am very

thin and my neck is small, the swelling and the healing

was " tightening " and impinging on my vocals. so my vocal chords were

not paralyzed but they were being squeezed temporarily. sure enough,

each day since, my problems have resolved. i feel very bad for you as

you had your surgery in may and it has been a few months. i think

that if your problems were due to healing, you should at least

gradually improve.

my surgeon did tell me back then that if the prblems did not resolve,

he would send me to an ent, who would be able to improve the

situation. he told me that someimes, the intubation itself during

surgery would cause the swallowing problems. we set out with the

plan to give the healing process some time. I had asked what would

happen next if things didn't improve and my surgeon gave me a few

options. one would be to go the ent. second would be to see a

therapist to help improve the functions with " exercises " . lastly,

more surgery.

my suggestion would be to go to another ent, then another, until you

are convinced that there would be nothing else they could do to

improve your situation. i know it is very frustrating and tiring and

discouraging at times. but my thing has always been to not take " no,

that's it " for an answer. drs. are human just like us and they are

not God.

in the meanwhile, i just thought i let you know that while i was

having the problems, sleeping a bit higher on the pillows did aleve

the breathing and the saliva drainage. as far as the swallowing, i

found that during my 1 week with the most noticeable swallowing

difficulties, i was able to swallow better when i tilt my head down a

bit with my chin towards my chest. this helped me swallow with less

effort. i remember the darn choking problems and even with my milder

ones, they were pretty unbearable. i feel your pain...and i hope you

find a doctor who will give you some good options.

hang in there! things WILL get better.

pap thyca 8.5mm

tt 9/5/02

rai 10/9/02

-- In Thyca@y..., " cmorais999 " <CMorais999@a...> wrote:

> Hi everyone,

> I am posting this question for someone who doesn't have a

> computer.

>

> Suzanne (mid-20s), had a TT and right neck dissection in May

> (pap thyca). The surgery left her with a paralyzed vocal cord. Most

> things she swallows now get stuck in her throat, sitting atop the

> paralyzed vocal cord. The only thing she can do is cough violently

> to dislodge the item. Sometimes this can take as long as 5 to 10

> minutes. The real problem she is having is with her saliva. She

> has woken up in the middle of the night a few times, unable to

> breathe because her saliva has gunked up in her throat. It is a

> very terrifying experience.

>

> She has been examined by an ENT who says the cord is best

> left where it is, so she is stuck with this situation.

>

> Her question: Is anyone else here in the same boat? How have

> you learned to deal with the situation? Any suggestions you can

> give?

>

> Thanks very much!

> --Carmen in nyc

> TT 10/00, papthyca, 100mci RAI 11/00

October 5, 2002

Hi, Carmen, and welcome back - it's been a long time since you've written.

Thankfully, I'm not in the same boat, and I don't recall seeing the same

situation addressed here, although gave you some great tips.

I would suggest seeing another doctor (and like says, another and

another and another ...), and also possibly a speech pathologist who should

be able to provide some assistance.

I assume the ENT has considered and rejected doing a thyroplasty?

Tina wrote in about having a thyroplasty for relief from her paralyzed

vocal cord, and was very satisfied with the results. Of course, I don't

know if Suzanne's situation is the same as Tina's, but it might be worth

investigating.

See http://groups.yahoo.com/group/Thyca/message/19918

basic description of the procedure ....

http://www-surgery.ucsd.edu/ent/PatientInfo/voi_hoarseness.html

There is also a procedure called a vocal cord medialization.

.... from http://www.mayo.edu/mcj/ent/vocalcords.html ...

" Fortunately, the problem with swallowing liquids usually takes care of

itself over time and requires no treatment. However, if it persists for

months, a vocal cord medialization procedure may be helpful. This procedure

simply pushes the paralyzed vocal cord to the middle so that the

functioning, moving vocal cord can close off the larynx during swallowing.

This procedure improves both voice and swallowing. "

My impression from others who have had severe post TT vocal cord paralysis

is that it can repair itself as along as a year later, so Suzanne's

situation may still heal itself, although of course, I understand that

doesn't help her now. You didn't mention it, but I'm curious ... was her

voice affected?

Please keep us updated on Suzanne's situation.

thanks -

NYC

cmorais999 wrote: